CODEINE 10MG/CTM 4MG/PSEUDEFED 60MG/5ML SYRUP (4264) VA PRODUCT (50.68)

Name	Value
NAME	CODEINE 10MG/CTM 4MG/PSEUDEFED 60MG/5ML SYRUP
VA GENERIC NAME	CHLORPHENIRAMINE/CODEINE/PSEUDOEPHEDRINE
DOSAGE FORM	SYRUP
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	ALCOHOL STRENGTH: 5 UNITS: % SUCROSE CHLORPHENIRAMINE MALEATE STRENGTH: 4 UNITS: MG/5ML CODEINE PHOSPHATE STRENGTH: 10 UNITS: MG/5ML PSEUDOEPHEDRINE HYDROCHLORIDE STRENGTH: 60 UNITS: MG/5ML SACCHARIN
CS FEDERAL SCHEDULE	Schedule V
INACTIVATION DATE	2008-09-02 00:00:00
DSS NUMBER	3
NATIONAL FORMULARY NAME	CHLORPHENIRAMINE/CODEINE/PSEUDOEPHEDRINE SYRUP
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
TRANSMIT TO CMOP	NO
MASTER ENTRY FOR VUID	YES
VUID	4004816
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2008-09-02 00:00:00 STATUS: INACTIVE